SynthesisDigestive diseases and sciences2026
Impact of Age on Efficacy and Safety of Advanced Therapies During Induction in Ulcerative Colitis: An Individual Patient Data Pooled Analysis from Randomized Controlled Trials.
Synthesis in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
BACKGROUND AND
aimsWe evaluated whether age modifies treatment efficacy and safety of advanced therapies in patients with moderate-to-severe ulcerative colitis (UC).
methodsThrough an individual patient-level data (IPD) meta-analysis of 10 RCTs of advanced therapies (TNF antagonists: infliximab, adalimumab, golimumab; vedolizumab; ustekinumab; tofacitinib) in patients with moderate-to-severe UC, we compared the efficacy (induction of clinical remission, endoscopic improvement, endoscopic remission, and symptomatic remission) and safety (serious adverse events [SAEs] and infections) of induction therapy in older (≥ 60y) vs younger adults (< 60y). Modified Poisson regression was used to estimate the ratio of risk ratios (RRR) of treatment effects by age, adjusting for baseline endoscopic severity, disease duration, disease extent, prior biologic exposure, C-reactive protein, albumin, hemoglobin, concomitant corticosteroid use, and clustering effect by studies.
resultsAmong 6192 patients (mean age 39.6 years, 41% female), 634 (10.2%) were aged ≥ 60 years. Efficacy of all advanced therapies over placebo was similar in older vs younger adults, with no significant treatment effect modification (induction of clinical remission: TNF antagonists, RRR of older vs younger adults, 0.94 [95% CI, 0.41-2.15]; non-TNF-targeting agents, RRR, 1.26 [0.60-2.62]). However, older adults were significantly more likely to experience infections with advanced therapies vs placebo, compared with younger adults (TNF antagonists, RRR, 1.52 [1.12-2.05]; non-TNF-targeting agents, RRR, 2.04 [1.45-2.87]).
conclusionIn patients with moderate-to-severe UC, older age did not modify the magnitude of efficacy but was associated with higher magnitude of infection during induction with advanced therapies.
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